PROTECTION AGAINST UNSEALED SOURCES IN MEDICINE
Diagnostic jade isotope test uses radioactive tracer for studying lungs, I brain, liver, spleen, kidneys, thyroid, bone and blood. The radio nuclide selected depends upon the organ being studied e.g. calcium-47 or strontium-85 is bone seeking nuclides.
Under most circumstances the patient might be discharged immediately because of low activities.
RADIOISOTOPE THERAPY
In this method radiation therapy is carried out by the ingestion or injection of radio-nuclides solution into the body.
The nuclides been is one which concentrates in the organ needing treatment thus minimizing the doze to the rest of the body.
Patients containing therapeutic quantities of radio activity could be nursed under conditions which permit easy containment of radio activity in case of contamination.
Ideally special ward should be available in which all surfaces are designed to permit easy cleaning and filtered extract system are provided, protective gowns and gloves must be worn when handling the patients, contaminated linen or excreta and a special storage area is provided, for contaminated linen waste and samples of excreta.
The radiation safety officer specifies any limitations on time allowable for nursing procedures or visiting periods.
Washing and monitoring facilities must be provided for use when leaving the area and regular radiation and contamination survey have been made of the ward.
STORAGE OF RADIOACTIVE WASTE
Storage of radioactive waste has been regarded as a very useful procedure when ding with nuclides or relatively short half life e.g. up to a few months.
If we keep the waste for a period of having long half life this storage can only be considered ks a temporary solution.
DISPOSAL OF SOLID WASTES
A method practiced by smaller users of radioactive materials (hospitals, factories, universities etc) has been disposal with ordinary trade waste. The principle applied here is dilution, the old package having a small quantity of radio activity being well-diluted and buried among the vast quantities of ordinary trade and domestic waste on the local refuse tip.
RADIO ACTIVE WASTES
On a much smaller scale radio active wastes arise in hospitals, factories, research and teaching institutions because of the many applications of radiation. In such the complex treatment plant used at nuclear power stations would be much expensive and so disposal may be done by the normal refuse collection or sewage system.
There are three basic principles which may be applied in dealing with radio active waste, these are.
i. Delay and decay,
ii. Concentrate and store and
iii. Dilute and disperse,
CONTROL AND DISPOSAL OF RADIOACTIVE MATERIALS IN MEDICINES
A large hospital may be having a very large number of radio active sources; both sealed and unsealed, and so needs a special storage area located in a position which minimizes the risk of fire or flood damage. Leakage test are needed to be performed on all sealed source at least annually and any source showing significant leakage must be withdrawn from use immediately. Sources not in the main storage area should be kept and transported only in approved containers. These containers must be constructed so as to provide adequate shielding and adequate contaminant to disallow dispersal in the event of damage to the source. They should be clearly marked radio active and carry the standard trefoil symbol.
The general policy on radioactive wastes disposal from hospitals has been to use conventional local methods, whenever possible. Low level solid waste is removed with ordinary refuse and usually finds its way to the local refuse tip. Low level liquid wastes such as laboratory washing or excreta from patients get discharged to the normal sewage system.
As most of unsealed radioactivity used in medical work has been short lived, it is usually practicable to store high level waste until it decays to an acceptable level for discharge to the sewage system. High level waste of long half life whether solid or liquid, can be collected by or sent to the national disposal services of the country.
Records must be kept of all wastes discharges, both solid and liquid.
The data available shows that the number of the patients within the hospital is increasing day by day which create problems like, unhygienic conditions, insufficient health care facilities, delay in treatment and recovery causes' infection. A large amount of pathogenic and hazardous wastes have created numerous social problems resulting into social malaise and epidemic diseases. The load of patients is also increasing day by day on general and teaching hospitals due to lack of health care facilities in rural areas. The HMC, LRH and KTH are such example where solid waste management system is not matching with the available resources to meet the enormous challenge of disposing the wastes properly. It is, however, a fact that the waste produced by the HMC alone consists of many pathogen, hazardous and explosive materials like sputum containing patient's pus, cell excreta, vomiting, bleeding, gangrene organs, contaminated disposable syringes, infectious waste, chemicals, radiation and radio active wastes. Beside the Offensive smell and bad environment these wastes cause gastro intestinal diseases, parasitic disease, insects and pulmonary disease like tuberculosis. Similarly due to lack of proper management facilities and due to over crowding the patients as well as the public receive unnecessary radiation during x-ray and radio therapy.
In solid waste management preference is given to the quality rather than quantity of wastes. Wastes generated in hospitals like the HMC, LRH and KTH, are of various composition and characteristics. Its quantity varies with time and place. However these contain certain infectious and hazardous wastes, therefore, it is necessary to give proper attention for its management.
The liquid wastes produced in the HMC, LRH and KTH contain blood, pus excreta, vomiting, dressing and washing water, laboratories effluents and chemicals are drained in to the city sewerage system without any treatment and process. Throwing hospital water into the drains of the city makes good media for bacteria and other macro organisms. Therefore, where ever these polluted water goes it contaminates our soil and under ground water. Mostly big organs and imputed limbs in hospitals are return to the patients' relatives with great care and arc buried them. Still many diseased parts of the body are disposed off normally with other refuse. Syringes, needles, glucose bags, urine bags are collected by sweepers and are sold in market while there are patients having dangerous and contiguous diseases. Some pharmaceutical companies are involve in the business to purchase these items from bazaar and sold it for reuse. It creates a lot of problems and increases the ratio of post surgery infections. These disposable items play active role in the spread of infectious and killing disease like hepatitis (A, B,C), T.B, AIDS, and Typhoid, Although, the HMC administration have some understanding with some pharmaceutical companies to collect placenta directly from gynecology ward to dispose it. However some time the placenta is mixed with other refuse for final disposal.
ANALYSIS OF THE EXISTING SITUATION
Hospital waste management may be defined as the discipline which deals with the generation, collection, storage, transfer, transport, processing and lastly disposal of wastes in a manner that is in accordance with the principles of environmental & public health engineering, economic, aesthetic and ecological considerations. Hospital waste management needs its own administrative and field staff to remove and mitigate the waste within the available financial resources and legal framework. All of these factors are collectively responsible for a sound waste management set-up.
All hospitals including the HMC, wastes management is the central problem having grave consequences but little care is given to dispose it. The HMC with 681 beds in it, generate 2550 Kg of wastes every day in total and @ 1.75Kg/day. This volume of waste from HMC has increased the threat of causing numerous diseases than that of the total wastes generated in the whole city and cantonment area.
This much waste is generated from wards of and other Depts., while a large amount of waste is generated in the OPD, but mostly the waste is non infectious and there is no proper way of at source segregation. The hospital administration is trying best to dispose off the waste materials properly and in time but due to certain problems and difficulties they are not able to dispose off the waste in an efficient and proper way. As the hospital waste contains infecting waste special care should be taken while disposing of the waste of such nature. Due to over-crowding of hospital, visitors and patients awareness of the harmful effects of the infectious waste is highly unsatisfactory. The unhygienic environment in and around the hospital has the potential danger in creating greater complication for highly vulnerable patients. With no proper system and arrangement of waste collection, storage and transfer especially from hospitals have lethal effects and cause cross-infection. It is commonly being observed that the waste is lying in the premises of hospital in open area for several days. The organic nature of the waste undergoes into decomposition, so the public in general and the sanitary workers in particular are exposed to serious health hazards. The ultimate disposal of the waste result in an open dumping is a dangerous practice both for short and long time duration.
The present system of hospital lack proper planning and supervision. No scientific methods or treatment facilities like steam sterilization or incineration arc applied. Neither the hospital neither has its own proper arrangement nor has required equipment nor did it make any arrangement with the Municipal Corporation to give a special care while handling the hospital waste. Several carcinogenic compounds and chemicals, mercury and other heavy metals, X-Rays and other radiation materials are fond in abundance in affecting the community al large.
The situation in KHYBERPAKHTOONKHWA is very serious because of unawareness about the waste problems due to overcrowding in hospital with rapid increase in population. This problem has further deteriorated compounded because of rural migration to the urban centers and due to the huge influx of Afghan refugees and their settlement in and around the vicinity of
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